RE: PA Job Description

From:"Dawson, Glen"

Excellent Post!!!  No reason for anyone to complain about this one.  The one
thing you must give PA's is that they can't help but be swayed by that
unwritten rule that the histo-lab is for the flotsom & jetsom of lab
personelle.  This is a belief that is widespread and one which has been
around too long to be overlooked.  It's like being grouped in with the
stinky kids when you know you just showered this morning and I understand
why PA's wouldn't like it.  Perhaps when we magically get more respect and
more pay in the coming years (like I keep hearing about), it won't be so
tough to get lumped in with us.
Glen Dawson  BS, HT & QIHC (ASCP)
Lead IHC Technologist
Milwaukee, WI
-----Original Message-----
From: Barnhart, Tammy []
Sent: Tuesday, June 24, 2003 7:23 AM
To: 'Charles.Embrey'; 'Soto, Roxanne'
Cc: ''
Subject: RE: PA Job Description

I really hate to wade into this conversation, I'll regret it I'm sure.
However, I have been to many labs where the relationship between the PA and
the rest of the staff is terrible and effects productivity and efficiency.
In fact, almost every lab I have visited that has a PA seems to have the
same problem.  As I talked to staff about how come there is this conflict, I
have gotten the same answer time and time again. "The PA thinks he/she is a
Pathologist and refuses to help others when they are not busy" or "I am a
PA, I am paid too much to be doing that type of work". Charles, I appreciate
what you say in your response, about taking care of the gross bench.  But I
think the problem is illustrated by your comment on malpractice.  A PA
cannot commit true malpractice, all their work is signed off on by a
Pathologist.  Only the Pathologist can commit malpractice.  A PA does not
need to carry individual malpractice insurance.  What you have implied is
that you are a physician. The PA does have a unique relationship with the
Pathologist.  This will sometimes lead to resentment by the rest of the
staff at no fault of the PA. Although I am a HTL, I have also performed PA
duties (sometimes being the sole PA) for many years.  I am eligible to be a
fellow with the AAPA.  I now manage a lab that has had a PA for over 20
years.  When I first arrived, there was that classic resentment from both
sides.  The PA would be swamped and get no help from staff, or the lab would
be nuts and the PA would take a 2 hour lunch.  It was a mess.  Although the
original PA could not tolerate the transition of reporting to me vs the
Pathologists and no longer works here, we now a system where the "main" PA
is responsible for the bulk of the gross (getting help when needed), but is
cross-trained to help with histology duties as needed.  The degreed staff is
cross-trained to help with gross when things get busy or the PA needs a
vacation.  In other words, we are a team.  Yes, some are paid better than
others.  I try to match the education and pay to duties, but the reality is
the work must get done and the patient and Pathologist don't care how much
money you are taking home.
I believe there is a attitude among some PAs that they are not really a
member of the Histology lab, but one of the Pathologists' team.  The problem
with that attitude is that unlike the Pathologists, they spend their day in
the histology lab interacting with the rest of the staff.  Like it or not,
they are part of the histology team.  Until they accept the rest of the
staff's jobs as being equally important to patient care, the conflict will
continue and productivity will suffer.
Apologies to all I have offended and all those great PAs out there.
Tammy Barnhart, BS, HTL(ASCP)
Anatomic Pathology Supervisor
St. Alexius Medical Center
Bismarck, ND  

-----Original Message-----
From: Charles.Embrey []
Sent: Monday, June 23, 2003 2:10 PM
To: 'Soto, Roxanne'
Cc: ''
Subject: RE: PA Job Description

I'm sorry to hear of your difficulties.  It sounds like your PAs have gotten
a little spoiled and lazy.  When I first took my job here the techs had one
person assigned to help the pathologist gross in much the same way as you
described (they even had the tech turn the specimen order forms over as they
grossed).  I stopped that practice and pretty much gross alone.  I make
extra cassettes if I need them and close my own cassettes.  Anyone grossing
should double-check the case number and name.  If a PA is grossing cases
without checking the info then he is committing malpractice.  The lab aids
do set up the cases but that is all they do.  I clean my own instruments
between cases and hope that I would never ask to be "Babysat" as your folks
are.  It embarrasses me that things like that happen.  As far as the
processors most PAs have very limited knowledge of histology itself and have
never processed tissue, cut slides or done any staining.  It's just not in
the training.
Don't worry, as much as I would like to call your PAs up on their actions, I
won't post this on the PA webserver.

-----Original Message-----
From: Soto, Roxanne []
Sent: Monday, June 23, 2003 12:04 PM
To: 'Charles.Embrey'; 'Rushing, Roxane'; ''
Subject: RE: PA Job Description

I have been following this posting on the PA duties and I have a question.
I have read the job description that Charles sent and I am very confused
about this.  Can you tell me what exactly the PA's do at your sites?  We are
a multi-sited system and we have 4 PA's and 2 sites have 2 PA's in the
morning and the other 2 sites have 1 in the afternoon.  The PA's that we
have do not always verify the accession number is correct or that it matches
the reqs (as this is a lab aide job and they are PA's and it is not their
job to verify the lab aides work).  We have to have a Lab Aide work with
each PA, side by side, to close cassettes, clean instruments between
specimens, etc.  So, I have to pay these lab aides for full time work to
stand by the PA all day to basically make and close the cassettes.  I even
had one PA tell me that they were unfamiliar with the processors.  They do
no filing, no maintenance of equipment, no cleaning.  We even have 1 site
that if a PA calls out sick we need to send a histologists to be there all
day to act as a lab aide because they can't, or won't, do it one their own.
Is this typical?
One more thing----please do not copy this and put it on the PA list-server,
as I do not want, nor do I need, any more problems with our PA's.

-----Original Message-----
From: Charles.Embrey []
Sent: Monday, June 23, 2003 10:54 AM
To: 'Rushing, Roxane'; ''
Subject: RE: PA Job Description

Based on the AAPA
 Code of Regulations and reviewed by a committee of the
American Society of Clinical Pathologists (ASCP) in 1994

At the direction and under the supervision of a Pathologist(s), a
Pathologists' Assistant may perform the following tasks and assume the
responsibility for duties including the following:

 	 Preparation, gross description and dissection of human tissue
surgical specimens including:	

A. Assuring appropriate specimen accessioning.

B. Obtaining clinical history, including scans, x-rays, laboratory data,

C. Describing gross anatomic features, dissecting surgical specimens, and
preparing tissues for histologic processing.

D. Obtaining biological specimens such as blood, tissue and toxicological
material for studies such as flow cytometry, image analysis,
immunohistochemistry etc., and performing special procedures including
Faxitron imaging and tumor triage.

E. Photographing all pertinent gross specimens and microscopic slides.

F. Performing duties relating to the administrative maintenance of surgical
pathology protocols, reports and data, including the filing of reports,
protocols, photographic and microscopic slides; assuring the completion of
specimen coding; and billing.

G. Assuring proper maintenance of equipment, provision of adequate supplies,
and cleanliness of the surgical pathology suite.

H. Assisting in the organization and coordination of anatomic pathology

 	 Preparation of human postmortem examinations including:	

A. Ascertaining proper legal authorization for autopsy.

B. Retrieving the patient's medical chart and other pertinent data for
review with the attending pathologist(s).

C. Conferring with the attending pathologist(s) to identify any special
techniques and procedures to be utilized in the completion of the postmortem
examination, (e.g. cultures; smears; histochemical, immunofluorescence,
toxicological, viral, or electron microscopy studies etc.), and notifying
all personnel directly involved.

D. Notifying the physician in charge, the funeral home, and all other
appropriate authorities prior to the beginning of the autopsy; and
coordinating any requests for special specimen sampling (e.g. organ
transplantation, research, etc.).

E. Performing postmortem examinations which may include: external
examination; in situ organ inspection; evisceration; dissection and
dictation or recording of data such as organ weights, presence of body
fluids etc., and gross anatomic findings.

F. Selecting, preparing and submitting appropriate gross tissue sections for
frozen section analysis as well as for light, electron and immunofluorescent

G. Obtaining biological specimens such as blood, tissue and toxicological
material for studies including flow cytometry, image analysis,
immunohistochemistry etc.; and performing special procedures such as
coronary artery perfusion, central nervous system perfusion, enucleation,
inner ear bone dissection, spinal cord removal, etc.

H. Photographing the body, organs, microscopic slides and other pertinent

I. Gathering and organizing clinical information and data pertinent to the
preparation of the preliminary summarization of the clinical history.

J. Preparing the body for release (including indicating the presence of
biohazards such as contagious disease, radiation implants, etc.), and
releasing the body to the appropriate mortuary or funeral home

K. Performing duties related to administrative maintenance of anatomic
pathology protocols; photographic and microscopic slides; and assuring the
completion of coding.

L. Assisting in the organization and coordination of anatomic pathology

M. Assuring the proper maintenance of equipment, the provision of adequate
supplies, and the cleanliness of the autopsy suite.

 	 Performing such administrative, budgetary, supervisory, teaching,
and other duties as may be assigned.	

-----Original Message-----
From: Rushing, Roxane []
Sent: Monday, June 23, 2003 10:22 AM
To: ''
Subject: PA Job Description

Do any of you have an official P.A. job description that you would share?
(Not lab assistants, Pathologist Assistants, P.A.)

--e-mail or fax to 225-766-6050


Thanks in advance,

Roxane Rushing

Pathology Group of La.


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